Naevoid hyperkeratosis of the nipple and areola

Medicine Science | International Medical Journal, 2015

Nevoid hyperkeratosis of the nipple and areola (NHNA) is a rare condition, in which the skin of the nipple and/or areola becomes diffusely thickened, hyperpigmented, and covered with filiform or papular warty excrescences. Although it affects both men and woman, approximately 80% of cases ocur in women. Pathogenic mechanisms have been proposed but mainly unsubstantiated. Moreover, specific treatment guidelines do not exist partly because of the unknown pathogenesis of this disorder. We report a female patient with this rare condition.

International Journal of Dermatology, 2003

Dear Sir, Concerning the popular prescription of triple or double topical preparations in Latin America, we would like to relate the following case.

Surgical Science, 2021

Background: Within the spectrum of necrotizing soft tissue infections (NSTI), necrotizing fasciitis (NF) has been characterized by tissue and fascial necrosis with systemic toxicity. The objective was to determine and summarize the frequency and characteristics of breast NF and NSTI in the literature. Methods: Cases were obtained through PubMed, Google Scholar, Google, and from published article reference sections. One hundred twenty-three cases were gleaned from 96 articles that reported NF and NSTI of the breast (1924 through 2021). Results: NF was reported in 70 and NSTI in 53 cases (111 women and 12 men). Patients presented with swollen, painful breasts, erythema, bullae, crepitus, necrosis, gangrene, fever, tachycardia, and neutrophilia. Fifty-nine of 123 (48.4%) patients were septic on admission. The most frequent microorganisms were β hemolytic Group A Streptococcus, and Staphylococcus aureus. Treatment consisted of antibiotics, mastectomy and debridement with flaps, skin grafts or primary and secondary closure. Forty-four (63.0%) of the NF cases had chest wall involvement; of these, 18 (14.6%) involved the breast secondarily, P < 0.0001. There were twelve mortalities (9.8%): eleven (9.0%) with NF and one (0.8%) with NSTI, P = 0.007. Conclusions: Men and women with breast NF and NSTI presented with similar signs and symptoms and required the same emergent treatment as provided for NF and NSTI of the more common sites. As a time-sensitive disease, patients treated within 12 hours of admission had a better survival. Patients with NF were more likely to have sepsis on admission, a higher mortality, and fascial chest wall/muscle involvement than patients with NSTI.

Mastology

Necrotizing fasciitis is a severe soft tissue infection characterized by rapidly progressive diffuse necrosis of fascia and adjacent tissues, most reported in the abdominal wall, perineum, and extremities. Cases of idiopathic necrotizing fasciitis of the breast are rare and unrelated to risk factors. This study was conducted with a 19-year-old woman reporting mastalgia and phlogistic signs in her right breast, which evolved with serosanguineous blisters and extensive necrosis of the fascia and periareolar wall, characterizing the necrotizing fasciitis. Therefore, the authors aim to show the relevance of early diagnosis associated with prompt treatment and procedure for a better intervention outcome.

The Internet Journal of Plastic Surgery, 2019

Background: Necrotizing fasciitis (NF) is a severe, fulminant infection characterized by necrosis of subcutaneous tissue and fascia with associated systemic toxicity. Methods: A retrospective review of breast NF cases (January 2007 to December 2018) which originated primarily in breast tissue (PNF), or spread to the breast secondarily (SNF). Results: Five (63%) males and 3 (37%) females had an overall age (mean ± sd) of 46.4 ± 18 years, hospitalization 46.5 ± 20.3 days, and 10.4 ± 5.0 debriding/grafting. Females were older than males (median 51 vs 38 years). Six (75 %) patients had SNF and two (25%) had PNF with 5 partial, 2 unilateral, 2 bilateral and 1 simple mastectomies. Median age for PNF vs SNF patients was 72 vs 38 years. Bacteriology indicated: 3 cases of Group A Streptococcus pyogenes; 2 polymicrobial; 1 each of multiresistant Staphylococcus aureus, Pseudomonas, and Coagulase negative Staphylococcus. Overall mortality was 37.5%. Survivors were younger than the deceased 36.0...

Mastology

Indian Journal of Dermatology, 2013

Nevoid hyperkeratosis of the nipple and/or areola is a rare and benign disease, with poorly understood etiology and no definite therapeutic plan.

Dermatologic Surgery, 2006

BACKGROUND. Nevoid hyperkeratosis of the nipple and areola (NHNA) is a rare condition of unknown etiology. Verrucous thickening and pigmentation of the nipple and areola are the main features of the condition. Different therapeutic options, both medical and surgical, have been described.

Mastology, 2018

Fasciíte necrotizante é uma infecção agressiva que acomete o subcutâneo e fáscias superficiais por necrose, mais frequentemente encontrada em parede abdominal, períneo e extremidades. Raros casos foram descritos na mama e a literatura aponta a amamentação e procedimentos mamários prévios como fatores de riscos para essa condição. Apresentamos uma paciente no puerpério, de 27 anos, que apresentou uma fissura no mamilo direito associada à amamentação e que evoluiu com infecção local agressiva, com necrose extensa de fáscias e parênquima mamário caracterizada como fasciíte necrotizante. O trabalho visa apresentar a importância do diagnóstico precoce, principalmente com diferenciação para as mastites puerperais que possuem fisiopatologia e tratamento distintos, assim como a necessidade do tratamento adequado com desbridamento cirúrgico e antibioticoterapia de amplo espectro para evitar maiores complicações e o óbito.

Baylor University Medical Center Proceedings, 2022

Paget's disease of the nipple is a rare breast carcinoma of the nipple-areola complex and is often associated with an underlying in situ or invasive carcinoma. It clinically presents as a thickened, erythematous, weeping or crusted lesion with irregular borders. Paget's cells invading the epidermis are the hallmark histopathologic feature, and cytokeratin 7 staining is positive in nearly all cases. However, the diagnosis of Paget's disease may be delayed or missed in favor of clinically similar benign nipple processes such as nipple adenoma and nipple dermatitis. We present a case of Paget's disease of the nipple in a 73-year-old woman with a brief review of other common nipple diseases.